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Nurse directors face prosecution for poor care


Nursing directors who preside over organisations delivering poor care and neglect could face criminal prosecution in future, health minister Norman Lamb has said.

Speaking to Nursing Times following last week’s Liberal Democrat conference in Glasgow, Mr Lamb revealed more details of the government’s plans to introduce tougher penalties following poor care.

The move forms part of the government’s response to the public inquiry into care failings at the Mid Staffordshire Foundation Trust. A key recommendation in the inquiry report was the introduction of new fundamental standards of care which, if breached, could lead to prosecution.

Inquiry chair Robert Francis QC suggested examples of breaches could include patients being unnecessarily left in soiled beds. He wanted the threat of criminal action to extend not only to the organisation but to individual frontline members of staff.

The government has previously said it would introduce fundamental standards of care, and Mr Lamb revealed they would be backed by the threat of criminal sanctions, including for individual directors.

He told Nursing Times: “The powers to prosecute for what is essentially an offence of corporate neglect will apply to both the corporate body or the NHS trust or a director.

“The problem we have had is that the regulatory system for holding organisations to account has been flawed from the start.

“In the past, as long the organisation complied with a warning notice from the Care Quality Commission they couldn’t be prosecuted. For me that has to change,” he said. “The change we are making will apply to individual directors.” 

Mr Lamb noted that ministers were still finalising their full response to the Francis report into Mid Staffordshire, which is due to be published later this year and will include the policy on criminal sanctions. The government made its initial response to the report in March.

Robert Francis QC said NHS staff should face prosecution for the most serious neglect and abuse of patients and warned public confidence in the service could “evaporate” without it. He said the likely number of prosecutions would be extremely small, but the existence of a criminal sanction would focus the system on improving patient safety and quality of care.

However, the government has so far not made a decision on criminal action against staff below director level.

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Readers' comments (14)

  • tinkerbell

    Good. Bring it on! Not before time.

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  • Years ago working with psycho geriatric patients we used to do regular bed changing rounds....but some still lay in faeces for periods as we just couldn't keep up. It makes a great stick to flog nurses - but it is not always neglect!

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  • Anonymous | 24-Sep-2013 10:10 am

    Years ago working with psycho geriatric patients we used to do regular bed changing rounds....but some still lay in faeces for periods as we just couldn't keep up. It makes a great stick to flog nurses - but it is not always neglect!

    As no stranger to that patient group during my early staff nurse experience (late 1980s) I wonder how much soiling was due to poor prescribing, be that laxatives, bulk formers, over sedation etc, so I wonder how much of an issue it remains.

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  • Given that it's not unusual for patients to be discharged constipated -sometimes quite badly this will probably be the new short cut to managing this problem if it becomes a tick box target. Make managers accountable for staffing levels and front line staff only accountable when they are properly staffed and maybe trusts will stop looking to front line staff to make cost savings. Managers multiply at an alarming rate and to protect themselves look to bring in savings from below. We now have two band eights who do everything together and without a hint of irony tell us to work smarter when staffing levels drop even when it's by fifty percent.

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  • michael stone

    tinkerbell | 24-Sep-2013 7:41 am

    I'm with you - 'bring it on' is my gut instinct.

    But I still suspect that the copious amount of 'box-ticking' and record-keeping in the NHS, is likely to make it very difficult to pin blame on people who are 'away from the wards' - I still think those people will probably be able to create front-line situations in which it is hard to provide sensible and good care, and will STILL 'avoid being blamed'.

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  • About time they also prosecute other directors and executives (not just nurses) in all other areas of poor practice, such as management of resources and finance.

    Seems like most of the people at the top move sideways into other similar roles, once crippling change management have been implemented at any institution, while people on the frontline, delivering and/or receiving care are bearing the burden of their changes.

    Box ticking does not mean anything other than ticking a box. There are audits on audits, and some of this is getting in the way of actual patient care and ensuring staff are fit and resourced enough to do their job - hang a mo:

    Hourly patient alive check (tick) ;)

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  • tinkerbell

    if the people at the top know they are also going to be held to account about what happens on the ground floor this should be a step in the right direction, surely?

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  • This is great! The ones at the top putting pressure on nurses and ignoring nurses concerns and cries......
    My Trust is going through de-banding but all at the top and those well paid executive are ignoring the voices of concern nurses, about skill mix, staffing level, low on equipment, low ward stock etc....When incidents will start to occur, complains will start pouring in, investigations...., claims and payments then the government will want to know.
    All they are after is cost saving!
    So now it is great that they will be chasing these at the tops also.

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  • Anonymous | 24-Sep-2013 5:24 pm

    Do you honestly believe that they really will prosecute anyone at the top? The mechanisms already exist for this to happen. How many executives have we seen being prosecuted? This is just another meaningless, 'non' policy anoouncement to gain votes.

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  • Like others have said: it is about time.

    Those that sit in their air-conditioned offices,collecting their £100k plus salaries who make life and death decisions without ever having to meet patients face-to-face; who scuttle-off to another Trust or get promoted when things go tits-up, and who are never ever held to account. I think the prospect of doing jail time might focus their minds when they close beds, reduce nursing staff numbers and put poor patients at risk - jail the lot of 'em!

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